Since the beginning of September, Connecticut’s coronavirus numbers — from positivity rate to hospitalizations to deaths — have steadily risen, prompting state officials and medical experts to point to an ongoing spike and call for renewed discipline on masking and social distancing.

But while experts say the surge is alarming, it hasn’t reached nearly the levels of destruction that the state saw in the spring, or that some other states across the country are currently experiencing.

So how bad is Connecticut’s coronavirus spike right now? And how much worse could it get?

‘On the pathway to being bad’

It began on Sept. 9.

After reporting a positivity rate mostly below 1% for more than two straight months, Connecticut’s rate jumped above that threshold and then stayed there for more than a month, occasionally edging close to 2%. On Oct. 14, the rate hit 2.4% and again hovered in that range for a few days before jumping again to 3% on Tuesday.

Gov. Ned Lamont said at a press briefing last week that the rise in cases worries him. While the governor moved ahead with the third phase of reopening on Oct. 8, in the midst of the uptick, he has also acknowledged that the state isn’t in as good of a position as it was over the summer, when positive cases remained low from mid-June through the end of August. For example, there were 145 confirmed new cases on July 23, but on Friday the state reported 679 new confirmed cases.

“I’m concerned,” Lamont said. “I take nothing for granted.”

Positive case rate is typically an early indication of an outbreak or spike — residents first test positive for COVID-19, and then after several days or weeks, some of them are admitted to the hospital.

So, a few weeks after the positive rate began rising, hospitalizations began to do the same. Since Sept. 28, the state’s hospitalizations have more than tripled, and on Friday hit a four-month high of 233.

And shortly after more people were admitted to Connecticut’s hospitals, the state also began reporting an increase in the number of people dying with COVID-19.

The state reported 33 coronavirus-related deaths in the entire month of August. That number went up to 43 for the month of September. And by Friday, with still more than a week left in October, the state had already reported 69 deaths this month.

With rising numbers in all three of the state’s primary coronavirus metrics, there’s no doubt that Connecticut is seeing a COVID-19 spike.

“I would say we are on the pathway to being bad at the moment,” said Hartford HealthCare Chief Clinical Officer Dr. Ajay Kumar. “We’re not quite there yet, but we’re on the pathway to being bad.”

More controllable than the spring peak

Still, the ongoing spike doesn’t near the severity of the outbreak that Connecticut experienced in the spring.

At one point in mid-April, there were nearly 2,000 people hospitalized with COVID-19 across the state. Around the same time, the state reported triple-digit death numbers on some days.

“In March and April, we were reacting to the tsunami that was coming at us,” Kumar said. “It was uncontrollable.”

In the spring, as the virus tore across the state and ransacked nursing homes, the state had few of the tools it needed to fight back. Testing shortages lasted for weeks, medical experts had little if any treatments to boost a patient’s chances of surviving, and hospitals worried that their intensive care units would fill up and their ventilator stockpiles would run dry.

Connecticut is in an entirely different position now, Kumar said. While the state spent the spring scrambling to secure coronavirus tests and to implement precautions such as the mask mandate, now those measures are already in place.

“Right now, it’s different. We are more mature. We have a lot more knowledge. We have a lot more resources,” Kumar said.

The state’s hospitals are prepared to cope with the type of spike happening now, Kumar said. Hospitals have plans for how to expand their capacity if needed, they have treatment guidelines already in place for COVID-19 patients and they have stockpiles of medications such as remdesivir, which has been shown to reduce coronavirus patients’ time in the hospital.

Plus, the numbers just aren’t as bad as they were six months ago.

“It is a slow incline, not a sharp incline as we had before,” Kumar said. “That’s why I’m more comfortable in saying that let’s not panic. We will be fine. We’ll manage it through.”

But while the hospitals may be prepared to deal with a spike, rising cases in the community still mean more illnesses and more deaths.

‘Connecticut’s not an island’

Connecticut’s ongoing spike also pales in comparison to some of the outbreaks currently gripping other states across the country.

Connecticut had 0.8 deaths per 100,000 residents in the past week, according to The New York Times coronavirus tracker. Current hotspot North Dakota has seen 10 times that number — 8 deaths per 100,000 residents in the past week.

Similarly, while Connecticut has seen 94 new cases per 100,000 residents in the past week, North Dakota has seen 708 and South Dakota has seen 566.

But other states’ severe outbreaks could reach out across borders and into Connecticut. State officials, including Lamont, have acknowledged that COVID-19 doesn’t respect state boundaries.

“I think you all see what’s going on around the rest of the country with the spike in numbers, and Connecticut’s not an island unto itself,” Lamont said at a briefing last week.

While Connecticut’s spike isn’t of the level of the outbreaks raging in the Dakotas, White House coronavirus response coordinator Dr. Deborah Birx said during an early October visit to Hartford that Connecticut and other Northeast states are displaying trends that were seen in other states immediately before they became coronavirus hotspots.

But, Birx said, with the proper intervention the Northeast states don’t have to face the same fate.

“It’s early here,” Birx said in early October. “We can continue, in the Northeast, to contain the virus.”

In recent days, Connecticut’s outbreak has been significant enough to qualify the state for its own travel advisory. But Lamont, along with New York Gov. Andrew Cuomo and New Jersey Gov. Phil Murphy, agreed to exempt the three states from the travel advisory, which the governors have collaborated on.

How bad could it get?

As the weather turns colder and pushes people inside, as the holidays tempt families and friends to gather in larger numbers and as people grow weary of wearing masks and distancing themselves from loved ones, Kumar said he expects the state’s coronavirus outbreak will keep growing for at least a few more weeks.

“I think we are going to continue to see some more uptick over the next two to four weeks, especially [with] the holidays and everything else that’s coming up and some of the laxity in the community we have right now,” Kumar said.

If the outbreak continues to spread, that means more people will get sick and more people will die. But that doesn’t have to happen, according to Birx, Kumar and the state’s Acting Public Health Commissioner Dr. Deidre Gifford. All three say that residents’ behavior could be the difference between a continued outbreak and a return to lower case counts.

“A lot of this prevention, of turning this around, is within our own personal control,” Gifford said.

All three urged residents to recommit to wearing masks, keeping physical distance from others, staying home when sick and avoiding gatherings with people outside of their household. Birx and Gifford have said that small gatherings, in particular, have driven much of the recent spread in Connecticut.

“The fate of our future is in our hands as community members,” Kumar said.